autism

Autism

Definition

Autism is a complex developmental disorder distinguished by difficulties with social interaction, verbal and nonverbal communication, and behavioral problems, including repetitive behaviors and narrow focus of interest.

Description

Classic autism is one of several disorders categorized as autism spectrum disorders (ASD). Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder. According to the National Institutes of Health (NIH), three to six out of every 1,000 children in the United States have autism. Autism is four times more likely to be diagnosed in males. Autism is a disorder that is also prevalent worldwide. In the United Kingdom, one out of every 100 children have autism, with over half a million total diagnosed in the United Kingdom as of 2007. In China, one in every 1,000 children is diagnosed with autism. In India, the rate of incidence is 1 in every 250 children. In Mexico, two to six in every 1,000 children are autistic. Autism is not specific to any one socio-economic, ethnic, or racial group.Autism usually manifests before a child is three years old and it continues throughout his/her lifetime. The degree of impairment varies from mild to severe. Autism is treatable and, with early diagnosis and treatment, autistic children have the ability to lead healthy, full lives.

Causes and symptoms

Researchers know that autism is a complex brain disorder that affects the way the brain uses or transmits information. Studies have implicated several causes for the disorder but still more investigation is needed. Studies have found abnormalities in several parts of the brain that are believed to have occurred during fetal development. The problem may be centered in the parts of the brain responsible for processing language and information from the senses.There also appears to be a strong genetic basis for autism. Family studies have shown that identical twins are more likely to both be diagnosed with autism than twins who are fraternal (not genetically identical). In a family with one autistic child, the chance of having another child with autism is about one in 20 or approximately 5%, much higher than in the general population.The severity of the condition varies between individuals, ranging from the most severe (extremely unusual, repetitive, self-injurious, and aggressive behavior) to very mild. No one autistic child is alike in the manifestation of their symptoms so treatment options must be devised to treat each autistic child individually.Autistic children have different ways of learning and experiencing the world around them. Often autistic children have more acute reactions to sensory stimulation such as sound and touch. This results in avoidance of eye contact, physical contact, and oftentimes an aversion to music and other sounds. It is perhaps the way autistic children experience their world that causes difficulties with social interaction, language, and nonverbal communication.Profound problems with social interaction are the most common symptoms of autism and the most visible. Human beings are social and social interaction is present from birth onward. Children with autism have difficulty making social connections. A developmental milestone is when an infant can follow an object or person with his/her gaze. Autistic children tend to avoid eye contact altogether. They do not actively cuddle or hug but rather they passively accept physical contact or they shy away from it. They may become rigid or flaccid when they are held, cry when picked up, and show little interest in human contact. Such a child does not lift his/her arms in anticipation of being picked up. The child may appear to have formed no attachment to his/her parents, and does not learn typical childhood games, such as "peek-a-boo."Autistic children do not readily learn social cues. They do not know when or how to react to specific social situations or exchanges. Because of this, autistic children tend to look at and respond to different situations similarly. They do not understand that others have different perspectives and, therefore, autistic children seem to lack empathy.Because of their problems socially and the inability to translate social interactions appropriately, autistic children seem to have uncontrolled emotional outbursts, expressing themselves in a manner that does not suit the specific social situation of the moment.

Language problems

Verbal communication problems vary greatly for autistic children. Some children do not speak at all. Some will only use one or two words at a time. Some autistic children may develop vocabulary only to loose it. Other autistic children may develop an extensive vocabulary; however, they have difficulty sustaining a natural, "back-and-forth" conversation. Autistic children tend to talk in a sing-song voice or more robotically without emotional inflections. Often autistic children do not take body language into consideration and they take what is being said quite literally. Because of their impinged language skills and the inability to express their needs, autistic children seem to act inappropriately to get what they need. They may grab something without asking or blurt out statements.

Restricted interests and activity

Language and social problems inhibit social play for autistic children. Autistic children do not engage in imaginative play and role playing. They focus on repetition, some focusing on a subject of interest very intensely.Autistic children often stick to a rigid daily routine. Any variance to the routine may be upsetting to them and result in an extreme emotional response. Repetitive physical behaviors such as rocking, spinning, and arm flapping are also characteristic of autism. The repetitive behaviors are often self-soothing responses to sensory stimulation from the outside world.

Sensory problems

The sensory world poses a real problem to many autistic children, who seem overwhelmed by their own senses. A child with autism may ignore objects or become obsessed with them, continually watching the object or the movement of his or her fingers over it. Some children with autism may react to sounds by banging their head or flapping their fingers. Some high-functioning autistic adults who have written books about their childhood experiences report that sounds were often excruciatingly painful to them, forcing them to withdraw from their environment or try to cope by withdrawing into their own world of sensation and movement.

Diagnosis

There is no medical test for diagnosing autism. Diagnosis is made after careful observation and screening by parents, caregivers, and physicians. Early diagnosis is beneficial in treating the symptoms of autism. Some early warning signs are:

avoiding eye contact

avoiding physical contact such as hugs

inability to play make-believe

not pointing out interesting objects

not responding to conversation directed at him/her

practicing excessively repetitive behaviors

repeating words or phrases

loosing skills and/or language after learning them

Once parents feel there is a problem or their pediatrician has identified developmental problems during well-baby check-ups, they can seek out a developmental pediatrician for further diagnosis. There are several screening tests used. They are:

Childhood Autism Rating Scale (CARS)-a test based on a 15 point scale where specific behaviors are observed by the physician.

Checklist for Autism in Toddlers (CHAT)-a test to detect autism in 18-month olds that utilizes questionnaires filled out by both the parents and the pediatrician.

Autism Screening Questionnaire-a 40-item questionnaire for diagnosing children four and older.

Screening Test for Autism in Two-Year Olds-a direct observation of three skill areas including play, motor imitation, and joint attention.

Some children have a few of the symptoms of autism, but not enough to be diagnosed with the "classical" form of the condition. Children who have autistic behavior but no problems with language may be diagnosed with Asperger syndrome by using the Autism Spectrum Screening Questionnaire, the Australian Scale for Asperger's Syndrome, or the Childhood Asperger Syndrome Test. Children who have no initial symptoms but who begin to show autistic behavior as they get older might be diagnosed with "childhood disintegrative disorder" (CDD), another autistic spectrum disorder. It is also important to rule out other problems that seem similar to autism.

Treatment

Because the symptoms of autism can vary greatly from one person to the next, there is not a single treatment that works for every person. A spectrum of interventions including behavioral and educational training, diet and nutrition, alternative medicine and therapies, and medication should be utilized and fine-tuned to treat the individual. The most strongly recommended treatment option is behavioral and educational training. Early intervention and treatment is key to helping autistic children grow into productive adults.

Educational and behavioral treatment

Several educational and behavioral treatments are:

Applied Behavior Analysis (ABA)

speech therapy

occupational therapy, including sensory integration therapy

social skills therapy, including play therapy

Typically, behavioral techniques are used to help the child respond and decrease symptoms. This might include positive reinforcement to boost language and social skills. This training includes structured, skill-oriented instruction designed to improve social and language abilities. Training needs to begin as early as possible, since early intervention appears to positively influence brain development.Most autistic children respond to intervention at home as well as at school. Schools focus on areas where the child may be delayed, such as in speech or socialization. As autistic children grow and move to different phases of childhood and adolescence, parents in collaboration with educators and physicians need to adapt the treatment to best suit the needs of their autistic child.

Medication

No single medication treats symptoms of autism; however, some medications have been used to combat specific needs in autistic children. Drugs can control epilepsy, which afflicts up to 20% of people with autism. Medication can also treat anxiety, depression, and hyperactivity.Five types of drugs are sometimes prescribed to help the behavior problems of people with autism are:

stimulants, such as methylphenidate (Ritalin)

antidepressants, such as fluroxamine (Luvox)

opiate blockers, such as naltrexone (ReVia)

antipsychotics

tranquilizers

Alternative treatment

Many parents report success with megavitamin therapy. Some studies have shown that vitamin B6 with magnesium improves eye contact and speech and lessens tantrum behavior. Vitamin B6 causes fewer side effects than other medications and is considered safe when used in appropriate doses. However, not many health practitioners advocate its use in the treatment of autism, citing that the studies showing its benefit were flawed.

DMG (dimethylglycine)

This compound, available in many health food stores, is legally classified as a food, not a vitamin or drug. Some researchers claim that it improves speech in children with autism. Those who respond to this treatment will usually do so within a week. Again, many doctors do not feel that the studies are adequate to promote this treatment.

Diet

Many parents have seen beneficial affects from a gluten-free and casein-free diet. Gluten is a substance found in the seeds of cereal plants such as wheat, barley, oats, and rye. Casein is a protein found in milk. Often people have allergies to these substances without realizing it. Many foods have these substances as an ingredient; however, there is a growing number of gluten-free and casein-free foods available for people that would like to eliminate them from their diets.

Exercise

One researcher found that vigorous exercise (20 minutes or longer, three or four days a week) seems to decrease hyperactivity, aggression, self-injury and other autistic symptoms.

Prognosis

Autism is treatable but not curable. With appropriate treatments adjusted to suit the autistic child as he/she grows up, the symptoms of autism improve. Today, parents and caregivers are focused on providing the best therapies possible in order for autistic children to develop to their highest potential. Because the incidence of autism seems to be increasing at a rapid rate worldwide, enough so that the CDC has voiced concern about its prevalence, there is more awareness of autism and more ongoing research efforts. People with autism have a normal life expectancy and with proper intervention they can lead full lives.

Prevention

Until the cause of autism is discovered, prevention is not possible.

Key Terms

Antidepressants

A type of medication that is used to treat depression; it is also sometimes used to treat autism.

Asperger syndrome

Children who have autistic behavior but no problems with language and no clinically significant cognitive delay.

Encephalitis

A rare inflammation of the brain caused by a viral infection. It has been linked to the development of autism.

Fragile X syndrome

A genetic condition related to the X chromosome that affects mental, physical and sensory development.

Major tranquilizers

The family of drugs that includes the psychotropic or neuroleptic drugs, sometimes used to help autistic people. They carry significant risk of side effects, including Parkinsonism and movement disorders, and should be prescribed with caution.

Opiate blockers

A type of drug that blocks the effects of natural opiates in the system. This makes some people, including some people with autism, appear more responsive to their environment.

Phenylketonuria (PKU)

An enzyme deficiency present at birth that disrupts metabolism and causes brain damage. This rare inherited defect may be linked to the development of autism.

Rubella

Also known as German measles. When a woman contracts rubella during pregnancy, her developing infant may be damaged. One of the problems that may result is autism.

Stimulants

A class of drugs, including Ritalin, used to treat people with autism. They may make children calmer and better able to concentrate, but they also may limit growth or have other side effects.

Tuberous sclerosis

A genetic disease that causes skin problems, seizures, and mental retardation. Autism occurs more often in individuals with tuberous sclerosis.

For Your Information

Resources

Books

Tuchman, Roberto and Isabelle Rapin, eds.Autism: A Neurological Disorder of Early Brain Development. London: MacKeith Press for the International Child Neurology Association, 2006.

autism

au·tism

(aw'tizm),

A mental disorder characterized by severely abnormal development of social interaction and of verbal and nonverbal communication skills. Affected people may adhere to inflexible, nonfunctional rituals or routines. They may become upset with even trivial changes in their environment. They often have a limited range of interests but may become preoccupied with a narrow range of subjects or activities. They appear unable to understand others' feelings and often have poor eye contact with others. Unpredictable mood swings may occur. Many demonstrate stereotypical motor mannerisms such as hand or finger flapping, body rocking, or dipping. The disorder is probably caused by organically based central nervous system dysfunction, especially in the ability to process social or emotional information or language. Compare: Asperger disorder.

[G. autos, self]

autism

autism

(ô′tĭz′əm)

n.

Autism spectrum disorder, especially a more severe form of the disorder characterized by significant impairments in social interaction and communication, highly repetitive behavior, and strong resistance to change.

au′tist n.

au·tis′tic(-tĭk) adj. & n.

au·tis′ti·cal·ly adv.

autistic disorder

A pervasive developmental disorder, which affects 1:2500 children with a 3–4:1 male:female ratio, onset usually by age three.

au·tism

(aw'tizm)

A mental disorder characterized by severely abnormal development of social interaction and of verbal and nonverbal communication skills. Affected people may adhere to inflexible, nonfunctional rituals or routines. They may become upset with even trivial changes in their environment. They often have a limited range of interests but may become preoccupied with a narrow range of subjects or activities. They appear unable to understand others' feelings and often have poor eye contact with others. Unpredictable mood swings may occur. Many affected patients demonstrate stereotypical motor mannerisms such as hand or finger flapping, body rocking, or dipping. The disorder is probably caused by organically based central nervous system dysfunction, especially in the ability to process social or emotional information or language.

[G. autos, self]

autism

A serious childhood disorder of higher brain function in which the child is withdrawn, self-absorbed, aloof, interested in objects but not in people, prone to repetitive movement and sometimes self-injury, and often unable to communicate by normal speech. Autism is now regarded as a spectrum disorder with mild ASPERGER'S SYNDROME at one end and grossly disabling autism at the other. There are growing indications that it is the result of the lack of MIRROR NEURON activity in various parts of the brain leading to the inability to learn by immitiation and distinguish between the recognition of people and the recognition of inanimate objects. The single most consistent physical sign of autism is abnormal enlargement of the head. This is strongly associated with polymorphism of the HOXA1 gene. No association has been demonstrated between autism and the use of the MMR vaccine. The incidence of autism appears to be about 2.6 cases per 1000 live births. The condition can be reliably diagnosed between the ages of 2 and 3 and must be distinguished from simple mental retardation, emotional deprivation, early onset epilepsy, Rett syndrome and various neurodegenerative disorders.

autism,

n mental disorder in which language and social and relational skills are undeveloped. Individuals can be abnormally socially withdrawn.

au·tism

(aw'tizm)

Mental disorder characterized by severely abnormal development of social interaction and of verbal and nonverbal communication skills. Affected people may adhere to inflexible, nonfunctional rituals or routines. They may become upset with even trivial changes in their environment.

[G. autos, self]

autism,

n a developmental disorder usually appearing in children before the age of 3 that is characterized by communication, behavioral, and sensory impairments, including the inability to interact with others in a socially acceptable manner. The condition may require a special approach when working with the patient as well as when instructing in oral care.

Patient discussion about autism

Q. What is childhood autism exactly?

A. i'm sorry to say but probably not..it's a pretty severe diagnosis. but i'm no expert on the subject and not a prophet. about what it means later in life- this should be fronted to a professional.god bless.

Q. what is the definition of Autism? how would i know if one is autistic and the other one is not , or has only minor disorder ?

A. Autism is a brain development disorder that is characterized by impaired social interaction and communication, and restricted and repetitive behavior, all starting before a child is three years old. This set of signs distinguishes autism from milder autism spectrum disorders (ASD) such as pervasive developmental disorder not otherwise specified. Diagnosis should be made if suspected, by a specialits in child psychiatry or child developement.

Q. What is the definition of Autism?

A. Autism is defined by symptoms from each of the following three categories: qualitative impairment in social interaction, impairment in communication, and restricted repetitive and stereotyped patterns of behavior or interests.

By definition, the onset of autistic disorder is before the age of 3 years, although in some cases, it is not recognized until a child is much older.

It was difficult in the beginning," said Pilar's sister Gloria Martin, 45, of Santa Rosa, whose eldest son has autism and whose youngest son was diagnosed with pervasive developmental disorder, a variation of the disease.

Further analyses indicated that the link between the MET variant and autism appeared primarily in families with two or more affected children, the researchers report online this week for an upcoming Proceedings of the National Academy of Sciences.

Second, this research study updates the existing literature concerning students with autism in the field of special education in Kuwait and gives information for all Kuwaiti special education teachers, university faculties, and policy makers in the Kuwait Ministry of Education.

On June 12, Audax Health and Autism Speaks will co-host a live chat on the Autism Speaks Facebook page with Phillip Parham, a contestant on season six of NBC's "The Biggest Loser: Families" and parent of a child with autism, and Eric Chessen, M.

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